Orthopedic Coding Alert

Question: My orthopedic surgeon performed an assist at surgery in another town, and then performed of the postoperative care at our office. The insurer denied our postoperative care and only paid me for the surgical assist. What did I do wrong?

Alaska Subscriber

Answer: Although primary surgeons are subject to the global postoperative period, assistant surgeons are not.

You should append modifier -80 (Assistant surgeon) or -82 (Assistant surgeon [when qualified resident surgeon not available]) to the surgical CPT code when you report your physician's surgical assist.

This way, the payer won't bundle your postoperative services into the postoperative period, and you can report E/M codes (99211-99215 for established outpatients) for your postoperative care.